A pharmacoeconomic study of different brands of commonly prescribed antihypertensive drugs
Keywords:Antihypertensive, Pharmacoeconomic, Cost variation, Upasani
Background: The hypertension is the most common chronic disease, therefore treatment should be affordable. The antihypertensive drugs of same strength are available in market at different costs. This study was undertaken to create awareness among health care workers and patients, about cost difference among different brands of same antihypertensive drug. So that whenever possible, a cheaper effective brand can be prescribed to ensure better patient adherence.
Methods: Maximum retail price (MRP) of various antihypertensive drugs of same strength, manufactured by different pharmaceutical companies was obtained from various offline and online sources. The minimum and maximum cost of 10 tablets/capsules noted. The cost ratio and percentage cost variation was calculated for single drug and fixed dose combinations. The ceiling price (as per DPCO) of essential antihypertensives (as per national list of essential medicines) was compared with their maximum cost.
Results: The formulations of single antihypertensive drugs (41) and fixed dose combinations of two drugs (19) and three drugs (9) were included in the study. Among the single antihypertensives analyzed the highest cost difference was of eplerenone (50 mg) and high cost ratio and cost variation percentage was of amlodipine (5 mg). Among fixed dose combination of two drugs analyzed highest cost difference was found that of hydrochlorothazide (12.5 mg)+olmesartan (40 mg) combination and highest cost ratio and percentage cost variation was of amlodipine (5 mg)+telmisartan (40 mg).
Conclusions: There was a huge price variation among the antihypertensive drugs manufactured by various companies. Some measures must be taken by the government to bring the uniformity in the price that will help to reduce the economic burden on the patients.
GBD 2016 Risk Factors Collaborators. Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks, 1990-2016: a systematic analysis for the global burden of disease study 2016. Lancet. 2017;390(10100):1345-422.
Kearney PM, Whelton M, Reynolds K, Muntner P, Whelton PK, He J. Global burden of hypertension: Analysis of worldwide data. Lancet. 2005;365(9455):217-23.
Gupta R, Xavier D. Hypertension: the most important non communicable disease risk factor in India. Indian Heart J. 2018;70(4):565-72.
Zhou D, Bo X, Zhao M, Wang L, Veeranki S. Uncontrolled hypertension increases risk of all-cause and cardiovascular disease mortality in US adults: the NHANES III linked mortality study. Sci Reps. 2018;8:9418.
Gupta R, Yusuf S. Towards better hypertension management in India. Indian J Med Res. 2014;139(5):657-60.
Kardas P, Bishai WR. Compliance in infective medicine. Adv Stud Med. 2006;6(7C):652-8.
Das SC, Mandal M, Mandal SC. A critical study on availability and price variation between different brands: impact on access to medicines. Indian J Pharm Sci. 2007;69(1):160-3.
Piette JD, Heisler M, Wagner TH. Cost-related medication underuse among chronically ill adults: The treatments people forgo, how often, and who is at risk. Am J Public Health. 2004;94:1782-7.
Kumar V, Gupta NV, Kumar KA. A comparison between old and latest systems in DPCO. Int J Pharm Pharmaceut Sci. 2014;6(2):19-20.
Government of India Ministry of Chemicals and Fertilizers Department of Pharmaceuticals National Pharmaceutical Pricing Authority. Available at: https://www.nppaindia.nic.in/wp-content/uploads/2020/03/1-1.pdf.
Rivers PA, Glover SH. Health care competition, strategic mission, and patient satisfaction: research model and propositions. J Health Organ Manag. 2008;22(6):627-641.
Mir SA. A calm look at the cost of various brands of antiasthmatic drugs available in India. Int J Basic Clin Pharmacol. 2016;5:142-5.
Central Drugs Standard Control Organization. Fact sheet: National List of Essential Medicines, 2015. Available at: https://cdsco.gov.in/opencms/opencms/en/consumer/Essential-Medicines/. Accessed on 15 May 2021.
Mir SA. Cost variation analysis of different brands of commonly prescribed antihypertensive drugs, available in Indian market: a pharmacoeconomic study. Int J Basic Clin Pharmacol. 2018;7(3):556-60.
Karve AV, Chattar KB. Cost analysis study of oral antihypertensive agents available in Indian market. Int J Basic Clin Pharmacol. 2014;3(3):479-83.